Organization
FAYETTEVILLE VAMC
Active
Other names
SPRINGFIELD MO VA CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1850 WEST REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(479) 587-5912
(479) 587-5875
Mailing address
PO BOX 94494, CLEVELAND, OH 44101
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2636263
NCPDP
MO
Enumeration date
05/07/2008
Last updated
07/21/2022
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